Avalondental Group

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

DN17986 Issued in FL

Legal business name

AVALONDENTAL GROUP

Practice address

12950 E Colonial Dr Ste 124
Orlando, FL 32826-4609

Phone

(407) 281-1119

Fax

(407) 381-3711

NPI assigned

Aug 3, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Nga K Van, D.M.D

Title

Dentist

Phone

(407) 281-1119

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343952000000",
    "number": "1942556337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12950 E COLONIAL DR STE 124",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328264609",
            "telephone_number": "407-281-1119",
            "fax_number": "407-381-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12950 E COLONIAL DR STE 124",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328264609",
            "telephone_number": "407-281-1119",
            "fax_number": "407-381-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALONDENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-03",
        "last_updated": "2012-08-03",
        "status": "A",
        "authorized_official_last_name": "VAN",
        "authorized_official_first_name": "NGA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "407-281-1119",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": "FL",
            "license": "DN17986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003333500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Avalon Park Pharmacy Corporation
• Avalon Park Urgent Care
• Avalon SH Management
• Avalon'S Assisted Living
• Avalon'S Assisted Living II
• Sabrina Avalos
• Avante at Orlando, Inc.
• Avante Group, Inc.
• Avanthi Kopuri, DMD, MSD, Mha, PLLC
• Avawell Health LLC

• Public Health Dentistry in Orlando, FL
• Providers in Orlando, FL by specialty
• Public Health Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.